Random Cardio 2 Flashcards
Homeometric regulation
varies contractile force by changes in maximum velocity of shortening
NOT dependent on a change in rest length
Starling curve
Heterometric
Why might inc HR impair coronary BF?
Tachycardia shortens the diastolic interval, which may impair coronary flow since these vessels are perfused during diastole.
What change to BP may impair coronary BF?
any influence that lowers aortic diastolic pressure may compromise coronary blood flow
large fraction of total coronary flow occurs during diastole, so driving pressure at the entrance of the coronary arteries during diastole is an important factor to assure adequate flow
baroreceptor stim
respond to stretch (increased BP)
dec sympathetic firing
dec BP
inc parasympathetic stim
venous changes
inc venous capacitance
dec venous return
isoproterenol
non-specific B-agonist used in tx of bradycardia
“post-conversion pause”
Atrial fibrillation and sinus node dysfunction often coexist
rheumatic endocarditis lesions
Adherent, sterile, located at the closure margins and small and regular.
____ are the two most common causes of acquired valvular disease.
Calcific aortic stenosis and mitral valve prolapse
hypercoaguable state
adenoCA
–>
Non-bacterial thrombotic endocarditis
An anterolateral infarct indicates occlusion of which vessel?
LAD
The more severe the aortic stenosis, the ___ the murmur peaks.
later
large V wave
mitral regurg
endothelin
powerful vasoconstrictor
CK-MB returns to baseline
3-4 d
troponin returns to baseline
10 d
contraindicated in NSTEMI tx
lytic therapy (alteplase (tPA), reteplase (rPA) and tenekteplase (TNK-tPA))
transfer to Cath lab
IV heparin
aspirin
aspirin is approved for use in prevent CVD in which pt
aspirin is used for the secondary prevention of CAD and when the 10 year risk of ASCVD exceeds 10%
b-blocker to avoid in angina
acebutolol (intrinsic sympathetic activity)
type a dissection
proximal, more common
tx: surgical
type b dissection
descending, but can propagate up
tx: control HTN/sx. surgery has HIGH MORTALITY
most comm EKG abnormality in acute chagas
RBBB
hematoxyphil bodies
Libman sacks (SLE)
The aldosterone antagonists spironolactone and eplerenone have been shown to significantly reduce the mortality of patients with
heart failure and reduced LVEF
BNP
vasodilator promotes diuresis (favorable in HF)
Kussmal’s
Konstrictive Pericarditis
inc JVP w/ inspiration, ventricle cannot accept inc VR
brisk y descent
Constrictive pericarditis
rapid relaxation and suction of right atrium
LE edema
tamponade or constrictive pericarditis?
Constrictive pericarditis
rapid x descent
tamponade
blunted y descent
tamponade
CHADS score
risk fx for stroke in afib pt
CHF HTN Age >75 diabetes S2, stroke
L axis deviation
-30 - -90
R axis deviation
+90 - +180
lidocaine does not have a significant effect on
AV nodal conduction
P waves inverted in II, III, aVF
ectopic atrial arrhythmia
Trifascicular block
first degree AV block, RBBB and LAFB
foam cell
macrophage, smc
fixed split S2
ASD
inc BF on R side of heart
L –> R shunt
L vs R sided COP?
Left cardiac output < right cardiac output
small quiet heart
constrictive pericarditis
Which malignancies are particularly likely to metastasize to heart?
malignant melanomas
tumors comm assoc w/ cardiac involvement
malignant melanoma lung breast soft tissue sarcoma renal esophageal hepatocellular thyroid
shock w/ highest pulm a. O2 saturation
septic shock
non-specific arterial vasodilation and elevated cardiac output such that less oxygen is extracted by peripheral tissues than normal leading to a higher oxygen saturation
Matrix metalloproteinases degrade ____ support that prevents a plaque from rupturing.
collagen
A statin (HMG-CoA Reductase Inhibitor) is recommended when the 10-year ASCVD risk is greater than
7.5%
congenital rubella
PA stenosis
PDA
Beck’s triad
elevated JVP
hypOtension
muffled heart sounds
most comm cause of new systolic HFrEF
ischemic heart disease
increase in oxygen saturation between the mixed venous sample (from the vena cava or right atrium) and the pulmonary artery is caused by
VSD
HR < __ indicates bradycardia
60
ST segment depression in V4-V6 with a biphasic T-wave
LVH
diffuse left ventricular impulse
DCM
monomorphic VT
old scar caused by an MI prod a reentrant arrhythmia